47,XXX/45,X/46,XX mosaicism in a patient with Turner phenotype and spontaneous puberal development

Objective: To describe a patient with infertility and phenotypic combination of Turner and triple-X syndrome related to mos 47, XXX/45X/46,XX karyotype. Design: Case report. Setting: Division de Genetica, Centro de Investigacion Biomedica de Occidente and Hospital de Ginecologia y Obstetricia, CMNO, Instituto Mexicano del Seguro Social. Patient(s): The 24-year-old patient presented a phenotypic combination of Turner syndrome and X polysomy. She showed wide and short neck, low posterior hairline, cubitus valgus, bilateral shortening of the fourth and fifth metacarpals, multiple nevi, and mullerian anomalies but had spontaneous pubarche, thelarche, and menarche. Intervention(s): Laboratory evaluations, imaging studies, ovarian biopsy, G-banding karyotype, and in situ fluorescence hybridization. Main Outcome Measure(s): Clinical and laboratory findings. Result(s): A karyotype: mos 47, XXX/45X/46,XX was found in the cytogenetic studies, a bicornuate uterus in the ultrasonographic scan, and a normal ovarian profile in the laboratory tests. Conclusion(s): The infertility in the present case can be related to either bicornuate uterus or subclinical abortions due to aneuploid ova. Cytogenetic assessment provides important information regarding infertile patients with uterine factors and short stature. (Fertil Steril (R) 2009; 92:1747.e5-e7. (C)2009 by American Society for Reproductive Medicine.)